Original Notice.

     Preproposal statement of inquiry was filed as WSR 98-15-088.

     Title of Rule: WAC 246-915-085 Continuing competency.

     Purpose: These rules set the continuing competency requirements for licensed physical therapists. The proposed changes will create additional options for inactive therapists to maintain competence and clarify existing requirements.

     Other Identifying Information: The legislature has mandated that the Board of Physical Therapy establish and administer requirements for continuing competency as a prerequisite for the renewal of a physical therapy license.

     Statutory Authority for Adoption: RCW 18.74.023(4).

     Summary: The proposed changes expand the continuing competency options by allowing the use of articles, video, and other multimedia devices; expand the settings and opportunities for meeting physical therapy experience requirements; and improve the clarity of the rules.

     Reasons Supporting Proposal: The continuing competency requirement has proven problematic for physical therapists that choose not to practice in order to raise families or pursue other interests. The proposed rule creates additional options for inactive therapists to maintain competence and also clarifies existing requirements.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Kris Waidely, Program Manager, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4847.

     Name of Proponent: Department of Health, governmental.

     Rule is not necessitated by federal law, federal or state court decision.

     Explanation of Rule, its Purpose, and Anticipated Effects: The proposed changes are intended to provide greater flexibility or physical therapists to complete their continuing education requirements. The proposed changes will create additional options for inactive therapists to maintain competence and clarify existing requirements. The legislature has mandated that the Board of Physical Therapy establish and administer requirements for continuing competency as a prerequisite for the renewal of a physical therapy license. The proposed changes assure continued protection of consumers from incompetent physical therapy, while clarifying existing requirements and improving flexibility for physical therapists to maintain competency.

     Proposal Changes the Following Existing Rules: The proposal amends WAC 246-915-085 to expand continuing competency options for licensed physical therapists, and provide greater clarify for existing requirements.

     A small business economic impact statement has been prepared under chapter 19.85 RCW.

     Under RCW 18.74.023, the Board of Physical Therapy is empowered to establish and administer requirements for continuing competency as a prerequisite for physical therapy license renewal. RCW 18.74.023(4) calls for the establishment of continuing competency requirements and assurance of compliance before a physical therapy license can be renewed.

     Under WAC 246-915-085, the board, in part, defines continuing competency as continuing education and requires, in addition to two hundred hours of physical therapy related employment, evidence of forty hours of continuing competency in the form of continuing education every two years. The continuing education can be earned through classroom or correspondence coursework, cassette tape, videotape, or book review. However, continuing education comes in a variety of forms and methods such as classroom lectures, facility in-services, clinical observations video review, etc., that are measured in increments ranging from fifteen to sixty minutes.

     The board recognizes the almost universal conclusion that the current results of mandatory continuing education programs are debatably effective. Therefore, the board has not sought to limit the professional development and interests of licensed physical therapists to continuing education activities only. The board believes professional skills and knowledge can be maintained and enhanced through active practice. For this reason, the Board of Physical Therapy has attempted to create a balance by establishing a relatively moderate requirement of forty contact hours of continuing education as well as two hundred hours of employment every two years. The board believes this rule satisfies the legislative mandate to assure professional competence. This requirement has been in effect since 1994 and has met the approval of the more than 3,700 licensed physical therapists required to comply with it.

     Purpose and Objective: The Department of Health (DOH) is proposing a rule change that will:

•     Allow physical therapists to utilize their time more efficiently and effectively when completing their continuing education requirements.

•     Add clarity and enhance existing requirements for continued competency by clearing [clearly] specifying which continuing education requirements are acceptable for a given number of hours.

•     Maintain existing quality of care provided by well-informed and educated physical therapists.

     Rule-making Requirements of the Regulatory Fairness Act (chapter 19.85 RCW): The Regulatory Fairness Act, RCW 19.85.030 requires the department to conduct a small business economic impact statement (SBEIS) for proposed rules that have more than minor impact on small businesses. As defined in RCW 19.85.020 a small business is "any business entity, including a sole proprietorship, corporation, partnership, or other legal entity, that is owned and operated independently from all other businesses, that has the purpose of making a profit, and that has fifty or fewer employees."

     What does the proposed rule amendment do? The board proposes rule changes that will clarify, specify and add language to the requirements for continuing competency. The proposed amendment:

•     Adds the phrase "from birth date to birth date" to specify the two-year period for renewing licensure and completing continuing competence.

•     Omits the word "contact" describing the hours for continuing education.

•     Adds the requirement that only ten hours of continuing education may be used for book or article reviews.

•     Adds the requirement that credentials of the presenter of certificates of completing continuing education must be identified as a recognized authority.

•     Specifies that zero - four hours of running time of cassette and video must be reviewed for each two-page synopsis written by the licensee.

•     Specifies that one book or article on each subject must be reviewed for each two-page synopsis written by the licensee.

     Affected Industries/Disproportionate Impact: In preparing this small business economic impact statement (SBEIS), the Department of Health used the following SIC codes:

SIC	Description	MINOR IMPACT THRESH.
8051	Skilled nursing care facilities	$	195.64
8052	Intermediate care facilities	$	66.10
8059	Nursing and personal care, nec	$	66.10
8062	General medical & surgical hospital	$	396.57
8069	Specialty hospitals exc. psychiatri	$	237.94
8082	Home health care services	$	122.94
8093	Specialty outpatient clinics, nec	$	116.33
8099	Health and allied services, nec	$	66.10

     These eight SIC codes indicate a minor impact threshold of $66.10 - $396.57. Because the rule changes are only adding clarity to existing requirements and do not impose any major changes or requirements that affect the intent of the rule, there are no significant costs and additional burden. The estimated cost to health care practitioners and physical therapists for amending these rules is zero. Therefore, there is no disproportionate cost to small business.

     How the Department of Health Will Notify Businesses: Upon adoption, these rules will be made available to businesses that involve physical therapists, physical therapist assistants and physical therapy aides in a number of ways.

•     Available on the Internet via the Board of Physical Therapy website.

•     Copies sent to all businesses that have asked to be placed on the interested persons mailing list.

•     Included in the next updated law book which is sent upon request to businesses and licensees and available on the Internet.

•     Available at the front counter for businesses and licensees.

•     Copies mailed to appropriate schools.

•     Copies available through the Code Reviser's Office, available to all businesses, licensees, and the public at large.

     How the Department of Health Has Involved Businesses in the Rule-Making Process: During the comment period, town meetings were held and draft rules were sent to all Washington licensed physical therapists and all known physical therapist assistants through the Physical Therapy Association of Washington. Only comments in support of this amendment were received.

     Costs to the Department of Health to Administer the Regulation: There are no new additional costs to the Department of Health to amend these rules. No additional review time and no additional analyses are required as a result of the amendments.

     A copy of the statement may be obtained by writing to Department of Health, Board of Physical Therapy, P.O. Box 47868, Olympia, WA 98504-7868, phone (360) 236-4847, fax (360) 664-9077.

     RCW 34.05.328 applies to this rule adoption. This rule is significant because it creates a requirement for licensure.

     Hearing Location: Department of Health, 310 Israel Road S.E., Room 139, Tumwater, WA 98501, on February 27, 2004, at 1:30 p.m. - 2:00 p.m.

     Assistance for Persons with Disabilities: Contact Kris Waidely by February 23, 2004, TDD (800) 833-6388 or (360) 236-4847.

     Submit Written Comments to: Department of Health, Kris Waidely, P.O. Box 47868, Olympia, WA 98504-7868, fax (360) 664-9077, by February 23, 2004.

     Date of Intended Adoption: February 27, 2004.

January 20, 2004

Kris Waidely

Program Manager

OTS-6734.1

AMENDATORY SECTION(Amending WSR 98-05-060, filed 2/13/98, effective 3/16/98)

WAC 246-915-085   Continuing competency.   Licensed physical therapists must provide evidence of continuing competency in the form of continuing education and employment related to physical therapy ((must be submitted)) every two years. ((Licensees born in even numbered years shall submit their continuing competency record form with license renewal every even numbered year. Licensees born in odd numbered years shall submit their continuing competency record form with license renewal every odd numbered year.))

     (1) Education - Licensed physical therapists must complete 40 hours of continuing education every two years as required in chapter 246-12 WAC, Part 7.

     (a) Continuing education specifically relating to the practice of physical therapy((.));

     (((i))) (b) Participation in a course with specific goals and objectives relating to the practice of physical therapy;

     (((ii) Cassette tape, video tape)) (c) Audio or video recordings or other multimedia devices, and/or book/article review. A maximum of ten hours may be used for books/articles reviewed;

     (((iii))) (d) Correspondence ((coursework)) course work completed.

     (2) ((Physical therapy employment - 200 hours specifically relating to physical therapy.)) In addition to the requirements in subsection (1) of this section, 200 hours involving the application of physical therapy knowledge and skills, which may be obtained as follows:

     (a) In the clinical practice of physical therapy; or

     (b) In nonclinical activities that involve the direct application of physical therapy skills and knowledge, examples of which include, but are not limited to:

     (i) Active service on boards or in physical therapy school or education program accrediting bodies;

     (ii) Physical therapy teaching or presentations on:

     (A) Patient/client management, prevention and wellness;

     (B) Physical therapy ethics and standards of practice;

     (C) Professional advocacy/involvement;

     (iii) Developing course work in physical therapy schools or education programs or physical therapy continuing education courses;

     (iv) Physical therapy research as a principal or associate researcher; and

     (v) Physical therapy consulting.

     (3) Licensees shall maintain records of all activities relating to continuing education and professional experience for a period of ((seven)) four years. Acceptable documentation shall mean:

     (a) Continuing education. Certificates of completion, course sponsors, goals and objectives of the course, credentials of the presenter as a recognized authority on the subject presented, dates of attendance and total ((contact)) hours, for all continuing education being reported.

     (b) ((Cassette tape, video tape)) Audio or video recordings or other multimedia devices, and/or book/article review. A two-page synopsis of each item reviewed must be written by the licensee.

     (i) For audio or video recordings or other multimedia devices, a two-page double-spaced synopsis for every one to four hours of running time must be written by the licensee. Time spent writing a synopsis is not reportable.

     (ii) For book/article review, a two-page double-spaced synopsis on each subject reviewed must be written by the licensee. Time spent writing a synopsis is not reportable.

     (c) Correspondence ((coursework)) course work completed. Course description and/or syllabus and copies of the completed and scored examination must be kept on file by the licensee.

     (d) Physical therapy employment. Certified copies of employment records or proof acceptable to the board of physical therapy employment for the hours being reported.

[Statutory Authority: RCW 43.70.280. 98-05-060, § 246-915-085, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.74.023. 94-05-014 (Order 403B), § 246-915-085, filed 2/4/94, effective 3/7/94.]

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